Cross Post – Bipartisan Payment System Improvements Mean More Physician Participation and Better Patient Care

macra 3Since we are smack dab in the middle of our focus-month on physician regulatory relief, we wanted to highlight an opinion piece published by The Hill featuring the Alliance of Specialty Medicine and neurosurgery’s own Alex B. Valadka, MD, FAANS, FACS, president of the American Association of Neurological Surgeons. The article, “Bipartisan payment system improvements mean more physician participation and better patient care,” addresses a number of key points related to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and offers solutions on how to reduce regulatory burdens for specialty physicians.

Click here, to read Dr. Valadka’s op-ed.

Editor’s Note: We encourage everyone to join the conversation online by using the hashtag #RegRelief.

Posted in AANS Spotlight, Health, Health Reform, MACRA, Medicare, Regulatory Relief | Tagged , , , , , , , , |

Faces of Neurosurgery: Dr. Ann Stroink, a Tireless Advocate

HS 1Guest post from Kristopher T. Kimmell, MD (left)
Neurosurgeon at North Kansas City Hospital/Meritas Health
North Kansas City, MO

Tyler Martin Schmidt, DO (middle)
Neurosurgical Resident at University of Rochester Medical Center
Rochester, NY

Gabrielle Santangelo (right)
Medical Student at University of Rochester Medical Center
Rochester, NY

Patients often face difficult decisions regarding their health, both regarding cost and quality of life. Physicians should act as a guide to patients in this process, offering recommendations based on their expertise, not regulatory red tape. This generation of physicians are facing regulations that threaten their autonomy, and their relationship with patients like never before. Neurosurgeons and their patients are beholden to the whims of policymakers. As a result, individual neurosurgeons must learn to advocate for their specialty and for their patients. Ann R. Stroink, MD, FAANS is a neurosurgeon at the forefront of this advocacy effort. She is an indefatigable force, affecting policy change and promoting the vision of organized neurosurgery as the chair of the AANS/CNS Washington Committee.

Left to Right: Dr. Stroink, CMS Administrator Verma and former HHS Secretary Dr. Price

Left to Right: Dr. Stroink, CMS Administrator Verma and former HHS Secretary Dr. Price

Dr. Stroink describes the Washington Committee as the “only organization with the entire world of neurosurgery at the table.” Importantly, this allows for the cultivation of a unified voice when communicating with the lawmakers. Since beginning this role, she has been invited twice to talk to the leadership of the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS). “It’s nice to have them interested in what doctors have to say,” Dr. Stroink added. Two critical issues that Dr. Stroink plans to champion during her tenure as chair of the Washington Committee are quality of care and deregulation.  Dr. Stroink says with the extensive regulations surrounding medical practice that some of her patients are forced to a travel long distance for an office visit before the insurance companies will authorize a routine follow-up MRI (e.g., a patient being followed for a brain tumor) even when it has been ordered by a highly trained, board-certified neurosurgeon. “This is not just about quality; it is about not allowing the degradation of the practice of medicine,” Dr. Stroink states. Through much-needed deregulation, the “individual neurosurgeon’s practice will be viable, allowing optimal care of all patients,” she adds.

Dr. Stroink is hopeful but realistic about what can be achieved in her term with the Washington Committee. She wants to “turn the corner on the quality issues.” Right now, “government misses the mark with neurosurgery quality measures,” she says. She has confidence in the thoughtful and committed neurosurgeons that comprise the Washington Committee’s Neurosurgical Quality Council (NQC). Dr. Stroink’s most vital ally in her day-to-day work is Katie O. Orrico, JD, who serves as the director of the Washington Office. “She lifts the heavy load for the committee and is an incredible person because of how well she handles so much,” Dr. Stroink says.

Dr. Stroink leading the way at the AMA as chair of Reference Committee B (Legislation)

Dr. Stroink leading the way at the AMA as chair of Reference Committee B (Legislation)

Dr. Stroink’s suggestions for those looking to get involved or wanting to be better versed in policy and legislation? Become familiar with your home state’s legislation, follow social media which will have up-to-date information about bills going through the House of Representatives, and get involved in state and local medical association chapters. While not specific to neurosurgery, these societies offer opportunities to connect with colleagues and discuss issues important for medicine in your community. For neurosurgery specific information, she urges those interested to read newsletters from the Washington Office as well as subscribe to Neurosurgery Blog. Furthermore, the Council of State Neurological Societies (CSNS) is committed to providing timely information about policies that affect neurosurgeons and their patients. For the residents and medical students, Dr. Stroink recommends pursuing a master’s degree in your field of interest. Programs focusing on quality, outcomes and public health teach the language of policy and afford students versatility in the future.

Left to Right: Dr. Timmons, Rep. Phil Roe (R-Tenn.) and Dr. Stroink

Left to Right: Dr. Timmons, Rep. Phil Roe (R-Tenn.) and Dr. Stroink

Dr. Stroink moved into her role as chair of the AANS/CNS Washington Committee after Shelly D. Timmons, MD, PhD, FAANS, became the president-elect of AANS. Previously, Dr. Stroink served as the chair of the CSNS. “It was a natural move,” she says. Before rising to chair, she served seven years as a voting member of the Washington Committee and was well acquainted with neurosurgery’s legislative issues and advocacy projects. She also served on organized neurosurgery’s American Medical Association (AMA) delegation, collaborating with other medical profession specialties to advance the practice of medicine and preserve patient access to high-quality care. Now with the Washington Committee, she is focused on the field of neurosurgery and bringing a “powerful message to the Hill.”

Dr. Stroink completed medical school at Southern Illinois University, which she left to brave the Minnesota winters for residency at the Mayo Clinic. From there, she completed a fellowship in pediatric neurosurgery at Toronto’s Hospital for Sick Children (SickKids). Today, she remains active in neurosurgical practice, serving as a senior partner of the Central Illinois Neuro Health Sciences and holds various academic, research and leadership appointments.

There is no question that Dr. Stroink is a fierce advocate for the field of neurosurgery, practicing neurosurgeons and their patients — working to affect change on Capitol Hill. We are honored and privileged to have such an exemplary leader in our field and commend Dr. Stroink’s tireless efforts on behalf of organized neurosurgery.

Editor’s Note: We encourage everyone to join the conversation online by using the hashtag #RegRelief.

Posted in Access to Care, Faces of Neurosurgery, Guest Post, Health, Healthcare Costs, Regulatory Relief | Tagged , , , , , , , , , |

Physician Regulatory Relief: Breaking the Red Tape to Improve Patient Care

debGuest Post from Deborah L. Benzil, MD, FACS, FAANS
Chair, AANS/CNS Communications and Public Relations Committee
Mount Kismo Medical Group
Columbia University Medical Center
Mt Kisco, New York

We the people of the USA deserve better from our health care system. Whether one is a patient, physician, nurse, or another part of our medical community, the system has failed. This should not be considered a partisan issue, all sides have contributed in some way to the mess, and few have shown willingness to step outside narrowly defined definitions to seek meaningful solutions. Of particular note, the core value of the healing relationship between patients and their chosen physicians has been relentlessly invaded by federal, state and local regulations. As neurosurgeons, often taking care of some of the most critically ill patients, we often feel the excessive burden of mandates that contribute little or nothing to quality or value for our patients and their loved ones. Listed below are just a few examples:

  • Electronic medical records (EMR) — also known as electronic health records (EHR) — have failed miserably and are not designed for efficient physician use, are not interoperable across physician practices, hospitals and health care systems, and too often get in the middle physicians and patients;
  • Maintenance of Certification (MOC), intended to encourage lifelong learning and quality patient care, has become — for some specialties — a profit-driven, expensive and cumbersome system with little-proven gain;
  • FDA approval of new life-saving medications and devices is fraught with delays and burdensome administrative requirements;
  • Prior authorization for tests, procedures and surgeries has become a failed system on every level for physicians and patients, allowing insurance companies to delay and deny care, while at the same time reap extra profits;
  • Quality reporting — in various iterations for hospitals and physicians — has failed to demonstrate many benefits and improved patient outcomes and physicians continue to be penalized under flawed quality improvement systems; and
  • Multiple credentialing, licensing, and certification is time-consuming and burdensome and should not be so in today’s world of electronic information.

Throughout the coming weeks, Neurosurgery Blog will once again shine a laser spotlight on a single issue, Physician Regulatory Relief:  Breaking the Red Tape to Improve Patient Care. Our goal is not just to identify and relate burdensome regulations, but to offer real solutions that will address the issues and problems that prompted the mandates. To this end, we seek to be highly constructive as we explore this critical topic and we encourage you to join in the conversation online by using the hashtag #RegRelief.


Posted in Congress, Health, Health Reform, Healthcare Costs, HIT, MACRA, Medical Innovation, Regulatory Relief | Tagged , , , , , , , , , , , , , |